Organization Active NPI

Purchase Care LLC

  • General Practice Physician
  • Calvert City, KY
National Provider Identifier
1710047998
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PURCHASE CARE LLC
Practice address
503 5TH Ave
Calvert City, KY 42029
Phone
(270) 395-5388
Fax
(270) 395-1792
NPI assigned
Dec 11, 2006
Last updated
Feb 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles L Waller Jr., MD
Title
Medical Director
Phone
(270) 395-5388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

503 5TH Ave
Calvert City, KY 42029

Mailing address

PO Box 1175
Calvert City, KY 42029
Phone (270) 395-5388

Other identifiers 2

IdentifierTypeStateIssuer
65941718MedicaidKY
000000174371OtherANTHEM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1710047998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1175",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "42029",
            "telephone_number": "270-395-5388",
            "fax_number": "270-395-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 5TH AVE",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "42029",
            "telephone_number": "270-395-5388",
            "fax_number": "270-395-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURCHASE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "270-395-5388",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65941718",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000174371",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calvert City, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.